NPIMap

Individual provider Active NPI

Daniel W Vittum, MD

  • Family Medicine Physician
  • North Riverside, IL
National Provider Identifier
1164518320
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036104765 Issued in IL
Practice address
1800 Harlem Ave Ste a
North Riverside, IL 60546-1468
Phone
(708) 783-9800
Fax
(773) 780-9810
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036104765 IL Primary

Addresses

Primary practice location

1800 Harlem Ave Ste a
North Riverside, IL 60546-1468

Mailing address

1800 Harlem Ave Ste a
North Riverside, IL 60546-1468
Phone (708) 783-9800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dvittum@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041004000208 IL Practitioner - Family Practice 7416916705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Stanford University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1800 Harlem Ave
North Riverside, IL 60546-1468
Phone (708) 783-9800

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

Hospital & facility affiliations

  • John H Stroger Jr Hospital Hospital, Chicago, IL, CCN 140124

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Family Medicine CurrentSince May 12, 2015 Accepting new patients
Cook County CurrentSince May 12, 2015 Accepting new patients
Cook County Current Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1900 W Polk St
Chicago, IL 60612
Phone (312) 864-0060

Interoperability endpoints

  • Direct secure messaging: dvittum@direct.ccprovider.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1164518320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARLEM AVE STE A",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461468",
            "telephone_number": "708-783-9800",
            "fax_number": "708-783-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HARLEM AVE STE A",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461468",
            "telephone_number": "708-783-9800",
            "fax_number": "773-780-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITTUM",
        "first_name": "DANIEL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036104765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dvittum@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Riverside, IL

Sources for this page

Verify at the official NPI Registry.